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Over the past 20 years, improvement in the control of elevated blood pressure, or hypertension, has been achieved with medications and life style changes. Changes in medical management include individualized patient therapy, and increased involvement of patients in their own medical care. Prescribing antihypertensive medication requires consideration of many factors; effectiveness of the drug is only one factor. Other factors must include: the cost of the drug; the schedule on which it must be taken and the likelihood of patient compliance; effects of the medication on other concomitant conditions; and adverse drug effects. Various antihypertensive medications have been reported to cause troublesome physical side effects that affect quality of life. Most studies concerning drug effects on the quality of life have used populations of active, middle-aged white employed men. This study evaluated the impact of these medications on a disadvantaged population consisting of 106 hypertensive patients who were predominantly elderly, black women. The majority (58 percent) had incomes under $10,000 per year and 56.6 percent were ineligible for Medicaid or Medicare. Patients were treated with one of the following medications: hydrochlorothiazide-triamterene, metoprolol, captopril or methyldopa. Quality of life measurements were taken before, and during medication therapy. The results revealed that metoprolol, captopril and methyldopa significantly lowered blood pressure. Quality of life indicators did not differ significantly among the four medications. These findings contradict recent studies which reported that captopril increased the quality of life, whereas the other medications decreased it. (Consumer Summary produced by Reliance Medical Information, Inc.), A sample of family practice patients with essential hypertension (N = 106) who were predominantly elderly, black, and disadvantaged were studied to determine psychosocial and physiological side effects from antihypertensive therapy regimens. Patients were assigned randomly to one of four monotherapy treatment groups: Hydrochlorothiazide-triamterene, metoprolol, captopril, and methyldopa. These medications have been reported to have contrasting effects on quality of life. Measurements of quality of life, physical symptoms, and depression taken at baseline and during therapy revealed few significant changes in these indicators. Changes in mean levels of diastolic and systolic hypertension over time were clinically and statistically significant Findings raise issues regarding medication effectiveness and cost given the disadvantaged population studied J FAM PRACT 1990; 30:143-152., In the past two decades improved surveillance and treatment of high blood pressure, mainly in primary care settings, has dramatically increased the percentage of patients with diagnosed hypertension who have [...]

Issue Depression is one of the most prevalent psychiatric disorders and when co-occurring with medical illnesses likely creates a vicious circle in which each separate ailment makes treatment outcomes worse [...]